your benefits communications may as well be in shakespearean verse

April 23, 2010

in communication

in honor of the bard’s birthday, let’s reflect on your average employee benefits handbook. here’s a snippet from a section that explains what’s covered:

For In-Network services, Eligible Charges are determined by: (a) XXXXX’s negotiated arrangements; (b) pre-determined fee schedules; and (c) the applicable Reimbursement Rate. For Out-of-Network services, Eligible Charges are determined by: (a) XXXXX’s Usual, Customer and Reasonable (UCR) Fees; (b) a provider’s contracted fee schedule; (c) the applicable Reimbursement Rate; or (d) negotiated fees. Reimbursement for Out-of-Network and Participating Providers is based on Eligible Charges for the type of service a Member receives (for example, Hospital or Physician services.) Reimbursement for Non-Contracted Providers is determined by our Default Reimbursement Rate. Out-of-Pocket Limits are accumulated for Preferred and Non-Preferred Providers as shown in the Summary of Benefits.

Lifetime Maximum Benefit
Any eligible Member is covered under the Group Contract to a total Lifetime Maximum Benefit as stated in the Summary of Benefits. This total amount of coverage includes certain services which have smaller lifetime maximums that are included within the total Lifetime Maximum Benefit. These maximums are also stated in the Summary of Benefits.

you may as well write it in iambic pentameter and throw in a few “thees” and “thous.” at least you’d confuse your employees with style.


note: thanks to @423comm for the tip re: shakespeare’s birthday. (it’s also hers.)

Leave a Comment

{ 7 comments… read them below or add one }

Frank Roche April 23, 2010 at 12:34 pm

Forsooth, this be glowing. I say, tarry not. Reade thee this missive.


fran April 23, 2010 at 12:53 pm

how now, sirrah? you do honor us with thou presence. i know thee recognize our plight. the cankerblossoms in legal – their might and number doth overwhelm us.



Ray Goldberg April 23, 2010 at 2:29 pm

Fran – Perhaps a benefits limerick would better demonstrate the absurdity of some of the content, too. Thanks for sharing this.



fran April 23, 2010 at 3:06 pm

ray, great idea. how to work “i once knew a girl” into some risque or maudlin benefits situation…hmmm.



Barbara Govednik April 24, 2010 at 3:30 am

Kind madam, I doth appreciate the pluggeth, so much preferred than slings and arrows. Outrageous fortune to us all!


Paul Smith April 25, 2010 at 2:22 pm

This is why I’m never annoyed by being asked the same questions repeatedly about benefit coverage.
It’s like speaking latin backwards…yes, that is what I’m saying…it was written by demons.


MarkSpizer May 2, 2010 at 6:47 am

great post as usual!


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